Journal: |
American Research Journal of Orthopedics and Traumatology
Egyptian journal of plastic surgery
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Abstract: |
Background: Lower one third of the leg is more prone to
trauma and more susceptible to develop exposed bone that
necessitate coverage with flap, the decision to choose flap is
difficult and depends on different factors, we tried to compare
3 sets of flaps used for coverage.
Patient and Methods: 33 patients were divided into 3
groups according to the type of flap coverage, most of our
patient were males and mean age was adult age group. 3
methods for coverage; group I free LD flap used, group II
crossed leg flap used, and group III coverage done with
perforator flaps.
Results: Most of the patient had rood traffic accident as
a cause of injury, most common defect in this study was at
the lower third leg, the LD flap group has the largest flap size
but it has long hospital stay and longer operative time, also
all cases require 2ry procedure, highly trained plastic surgical
team, the other 2 group had shorter operative time, in group
II, 2ry pedicle separation for all cases, easy and versatile flap,
difficulties for position fixation for 3 weeks, in last group III
had shorter operative time, shorter hospital stay, single operative
procedure but has limitation due to smaller flap size and
cannot be done if degloving injury occurred.
Conclusion: Flap coverage for lower one third leg defect
is difficult question to answer, a lot of flaps could be used
each method has its pros and cons, perforator flap is easy and
versatile with learning curve it can be used for small to
moderate size defects, cross leg flap remain as easy and
versatile flap and can be used as backup plan for other methods,
free LD flap provide large flap size used for large defects
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